Wall Climbing Waiver
I have read, understand, and agree to the following statements:
1. Rock climbing is an inherently dangerous sport and can potentially result in serious injury or death. 2. My use is voluntary and I assume all responsibility for any property loss or damage, bodily injury, or death resulting from my participation. 3. I am physically able and sufficiently skilled to participate in activities and use the equipment available. 4. I am obligated to conduct myself and to supervise my children, if any, in a safe and respectful manner including complete sobriety of alcohol and mind-altering drugs. 5. It is my responsibility to check and maintain the safety condition of all equipment used while participating in any climbing activities including personal, rented, and borrowed gear. 6. I am familiar and will comply with all rules and regulations and will obey all staff members. 7. I authorize and consent to emergency medical treatment or hospital care rendered to me or my child by any licensed medical professional. 8. Any photograph taken of me while utilizing the facility or participating in recreation activity may be used to publicize activities as deemed appropriate by Recreation Center staff. 9. I understand that failing to comply with the aforementioned standards may result in short or long term loss of facility use.10. I hereby waive, hold harmless, release, and discharge forever Recreation Center, their employees, coaches, volunteers, and other agents, from any and all liabilities, demands, claims, or cause of action resulting from property loss, damage, bodily injury, or death that may result from my participation, except as may arise solely from the gross negligence of the City Government.
Please fill in your name
Please fill in your email
Please fill in your age
Your signature
TO BE COMPLETED BY PARENT OR LEGAL GUARDIAN FOR PARTICIPANTS UNDER 18 YEARS OF AGE
PARENT/GUARDIAN NAME
Emergency phone number
Relationship to participant – must be parent/legal guardian
Parent/Guardian Signature